To study incidence characteristics and causes of injury, and its medical consequences in school children of China. Methods A total of 2 553 school children aged 7-16 years were recruited from Shantou City in Gunagd...To study incidence characteristics and causes of injury, and its medical consequences in school children of China. Methods A total of 2 553 school children aged 7-16 years were recruited from Shantou City in Gunagdong by cluster sampling method, and were investigated with questionnaires on cases of injuries occurred among them from October 1, 1996 to September 30, 1997. Results Injuries tended to increase with children抯 age, with an overall incidence rate of 37.96%, higher in boys than in girls (P<0.05); and 38.1% of children had more than two episodes of injury during this period. Falls took leading place of injury incidence both in boys and girls and in all age groups. Most injuries occurred when they were playing, sporting, riding and walking at home or in school. Self-inflicted injury ranked the first place of all injuries, followed by hurt caused by others (classmates, sibling or others). Moderate and serious injuries accounted for 8% of the total with a disability rate of 121.4/100 000. Conclusions Currently, injury has become one of the serious public health problems in China. For the improvement of children survival, it is crucial to reduce their injury to strengthen research on child safety and to implement safety-promotion programs.展开更多
Both domestic and foreign terror incidents are an unfortunate outgrowth of our modern times from the Oklahoma City bombings, Sarin gas attacks in Japan, the Madrid train bombing, anthrax spores in the mail, to the Wor...Both domestic and foreign terror incidents are an unfortunate outgrowth of our modern times from the Oklahoma City bombings, Sarin gas attacks in Japan, the Madrid train bombing, anthrax spores in the mail, to the World Trade Center on September 11 th, 2001. The modalities used to perpetrate these terrorist acts range from conventional weapons to high explosives, chemical weapons, and biological weapons all of which have been used in the recent past. While these weapons platforms can cause significant injury requiring critical care the mechanism of injury, pathophysiology and treatment of these injuries are unfamiliar to many critical care providers. Additionally the pediatric population is particularly vulnerable to these types of attacks. In the event of a mass casualty incident both adult and pediatric critical care practitioners will likely be called upon to care for children and adults alike. We will review the presentation, pathophysiology, and treatment of victims of blast injury, chemical weapons, and biological weapons. The focus will be on those injuries not commonly encountered in critical care practice, primary blast injuries, category A pathogens likely to be used in terrorist incidents, and chemical weapons including nerve agents, vesicants, pulmonary agents, cyanide, and riot control agents with special attention paid to pediatric specific considerations.展开更多
Traumatic brain injury(TBI)and spinal cord injury(SCI)are leading causes of death and disability worldwide(Center for Disease Control,2006).Both injuries are induced by external traumatic event and likely happen...Traumatic brain injury(TBI)and spinal cord injury(SCI)are leading causes of death and disability worldwide(Center for Disease Control,2006).Both injuries are induced by external traumatic event and likely happen together.After the primary traumatic incident,the secondary injury,including ischemic,inflammatory,metabolic and biochemical cascades,is likely more devastating(Blumbergs,1997).To date,all clinical trials have failed to cure TBI and SCI,due to the展开更多
Purpose:Spine injury is one of the leading causes of death and mortality worldwide.The objective of this study was to determine the incidence,pattern and outcome of trauma patients with spine injury referred to the la...Purpose:Spine injury is one of the leading causes of death and mortality worldwide.The objective of this study was to determine the incidence,pattern and outcome of trauma patients with spine injury referred to the largest trauma center in southern Iran during the last 3 years.Methods:This is a cross-sectional study conducted between March 2018 and June 2021 in the largest trauma center in the southern Iran.The data collection form included the age,sex,injury location(cervical,thoracic,and lumbar),cause of injury(traffic accidents,falls,and assaults),length of hospital stay,injured segment of spine injury,severity of injury,and outcome.Statistical analyzes were performed using SPSS software version 24.Results:Totally 776 cases of spine injury were identified.The spine injury rate was 17.0%,and the mortality rate was 15.5%.Cervical spine injury(20.4%)more often occulted in motorcycle accident,and thoracic spine injury(20.1%)occulted in falls.The highest and lowest rates of spine injurys were related to lumbar spine injury(30.2%)and cervical spine injury(21.5%),respectively.There was a statistically significant relationship between the mechanism of injury and the location of spine injury(p<0.001).And patients with lumbar spine injury had the highest mortality rate(16.7%).Injury severity score(OR=1.041,p<0.001)and length of stay(OR=1.018,p<0.001)were strong predictors of mortality in trauma patients with spine injury.Conclusion:The results of the study showed that the incidence of traumatic spine injury rate was approximately 17.0%in southern of Iran.Road traffic injury and falls are the common mechanism of injury to spine.It is important to improve the safety of roads,and passengers,as well as work envi-ronment,and improve the quality of cars.Also,paying attention to the pattern of spine injury may assist to prevent the missing diagnosis of spine injury in multiple trauma patients.展开更多
Background:Achilles tendinopathy(AT)is a common problem among runners.There is only limited evidence for risk factors for AT,and most studies have not defined the AT subcategories.No study has compared the incidence a...Background:Achilles tendinopathy(AT)is a common problem among runners.There is only limited evidence for risk factors for AT,and most studies have not defined the AT subcategories.No study has compared the incidence and risk factors between insertional AT and midportion AT,though they are considered distinct.This study aimed to assess incidence and risk factors of AT based on data from a large prospective cohort.The secondary aim was to explore differences in risk factors between insertional and midportion AT.Methods:Participants were recruited from among registered runners at registration for running events.Questionnaires were completed at baseline,1 month before the event,1 week before the event,and 1 month after the event.Information concerning demographics,training load,registered events,and running-related injuries were collected at baseline.The follow-up questionnaires collected information about new injuries.A pain map was used to diagnose midportion and insertional AT.The primary outcome was the incidence of AT.Multivariable logistic regression analysis was applied to identify risk factors for the onset.Results:We included 3379 participants with a mean follow-up of 20.4 weeks.The incidence of AT was 4.2%.The proportion of insertional AT was 27.7%and of midportion AT was 63.8%;the remaining proportion was a combined type of insertional and midportion AT.Men had a significantly higher incidence(5%,95%confidence interval(95%CI):4.1%-6.0%)than women(2.8%,95%CI:2.0%-3.8%).AT in the past12 months was the most predominant risk factor for new-onset AT(odds ratio(OR)=6.47,95%CI:4.27-9.81).This was similar for both subcategories of AT(insertional:OR=5.45,95%CI:2.51-11.81;midportion:OR=6.96,95%CI:4.24-11.40).Participants registering for an event with a distance of 10/10.55 km were less likely to develop a new-onset AT(OR=0.59,95%CI:0.36-0.97)or midportion AT(OR=0.47,95%CI:0.23-0.93).Higher age had a significant negative association with insertional AT(OR=0.97,95%CI:0.94-1.00).Conclusion:The incidence of new-onset AT among recreational runners was 4.2%.The proportion of insertional and midportion AT was 27.7%and 63.8%,respectively.AT in the past 12 months was the predominant risk factor for the onset of AT.Risk factors varied between insertional and midportion AT,but we could not identify clinically relevant differences between the 2 subtypes.展开更多
AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital.METHODS: Orthotopic liver transplantations performed from January 2006 unti...AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital.METHODS: Orthotopic liver transplantations performed from January 2006 until September 2012 were retrospectively reviewed(n = 187). Patients with no renal replacement therapy(RRT) before transplantation were classified into four groups according to their highest creatinine plasma level during the first postoperative week. The first group had a peak creatinine level below 12 mg/L, the second group between 12 and 20 mg/L, the third group between 20 and 35 mg/L, and the fourth above 35 mg/L. In addition, patients who needed RRT during the first week after transplantation were also classified into the fourth group. Perioperative parameters were recorded as risk factors, namely age, sex, bodymass index(BMI), length of preoperative hospital stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with β-blocker, angiotensin-converting enzyme inhibitor or non steroidal anti-inflammatory drugs, preoperative creatinine and bilirubin levels, donor status(cardiac death or brain death), postoperative lactate level, need for intraoperative vasopressive drugs, surgical revision, mechanical ventilation for more than 24 h, postoperative bilirubin and transaminase peak levels, postoperative hemoglobin level, amount of perioperative blood transfusions and type of immunosuppression. Univariate and multivariate analysis were performed using logistic ordinal regression method. Post hoc analysis of the hemostatic agent used was also done.RESULTS: There were 78 patients in group 1(41.7%), 46 in group 2(24.6%), 38 in group 3(20.3%) and 25 in group 4(13.4%). Twenty patients required RRT: 13(7%) during the first week after transplantation. Using univariate analysis, the severity of renal dysfunction was correlated with presence of ascites and prior bacterial infection, preoperative bilirubin, urea and creatinine level, need for surgical revision, use of vasopressor, postoperative mechanical ventilation, postoperative bilirubin and urea, aspartate aminotransferase(ASAT), and hemoglobin levels and the need for transfusion. The multivariate analysis showed that BMI(OR = 1.1, P = 0.004), preoperative creatinine level(OR = 11.1, P < 0.0001), use of vasopressor(OR = 3.31, P = 0.0002), maximal postoperative bilirubin level(OR = 1.44, P = 0.044) and minimal postoperative hemoglobin level(OR = 0.059, P = 0.0005) were independent predictors of early post-liver transplantation renal dysfunction. Neither donor status nor ASAT levels had significant impact on early postoperative renal dysfunction in multivariate analysis. Absence of renal dysfunction(group 1) was also predicted by the intraoperative hemostatic agent used, independently of the extent of bleeding and of the preoperative creatinine level.CONCLUSION: More than half of receivers experienced some degree of early renal dysfunction after liver transplantation. Main predictors were preoperative renal dysfunction, postoperative anemia and vasopressor requirement.展开更多
Background:Acute kidney injury(AKI)is a common and serious complication following lung transplantation(LTx),and it is associated with high mortality and morbidity.This study assessed the incidence of AKI after LTx and...Background:Acute kidney injury(AKI)is a common and serious complication following lung transplantation(LTx),and it is associated with high mortality and morbidity.This study assessed the incidence of AKI after LTx and analyzed the associated perioperative factors and clinical outcomes.Methods:This retrospective study included all adult LTx recipients at the China-Japan Friendship Hospital in Beijing between March 2017 and December 2019.The outcomes were AKI incidence,risk factors,mortality,and kidney recovery.Multivariate analysis was performed to identify independent risk factors.Survival analysis was presented using the Kaplan-Meier curves.Results:AKI occurred in 137 of the 191 patients(71.7%),with transient AKI in 43(22.5%)and persistent AKI in 94(49.2%).AKI stage 1 occurred in 27/191(14.1%),stage 2 in 46/191(24.1%),and stage 3 in 64/191(33.5%)of the AKI patients.Renal replacement therapy(RRT)was administered to 35/191(18.3%)of the patients.Male sex,older age,mechanical ventilation(MV),severe hypotension,septic shock,multiple organ dysfunction(MODS),prolonged extracorporeal membrane oxygenation(ECMO),reintubation,and nephrotoxic agents were associated with AKI(P<0.050).Persistent AKI was independently associated with pre-operative pulmonary hypertension,severe hypotension,post-operative MODS,and nephrotoxic agents.Severe hypotension,septic shock,MODS,reintubation,prolonged MV,and ECMO during or after LTx were related to severe AKI(stage 3)(P<0.050).Patients with persistent and severe AKI had a significantly longer duration of MV,longer duration in the intensive care unit(ICU),worse downstream kidney function,and reduced survival(P<0.050).Conclusions:AKI is common after LTx,but the pathogenic mechanism of AKI is complicated,and prerenal causes are important.Persistent and severe AKI were associated with poor short-and long-term kidney function and reduced survival in LTx patients.展开更多
Purpose:The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders.Methods:We systematically searched PubMed,Web of Science,and MEDLINE f...Purpose:The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders.Methods:We systematically searched PubMed,Web of Science,and MEDLINE for studies on injury incidence published from inception to April 2020.Injury data were extracted,alongside information on injury location,severity,type,cause,and sport discipline.Incidence of injuries was presented per 1000 athlete-days,with 95%confidence intervals(95%CIs).Results:The search identified 462 articles,and 22 were included in our review.The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days(95%CI:2.97-4.01).Lower extremity had the highest injury incidence(1.54 per 1000 athletedays,95%CI:1.24-1.84).Incidence rates of slight,mild,moderate,and severe injuries were 0.26,0.31,0.57,and 0.59 per 1000 athlete-days,respectively.Contusion had the highest incidence rate(1.82 per 1000 athlete-days,95%CI:1.01-2.63).The most common cause of injury was contact trauma(3.20 per 1000 athlete-days,95%CI:1.32-5.08).Freestyle skiing had the highest incidence rate(6.83 per 1000 athlete-days,95%CI:4.00-9.66),and Nordic skiing had the lowest rate(2.70 per 1000 athlete-days,95%CI:1.94-3.46).Conclusion:Professional skiers and snowboarders have a substantial risk of sustaining injuries.Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.展开更多
Background Clinical features of anterior cruciate ligament (ACL) injury are important for its prevention,diagnosis and treatment.However,few studies have reported such data,especially in China.The purpose of this st...Background Clinical features of anterior cruciate ligament (ACL) injury are important for its prevention,diagnosis and treatment.However,few studies have reported such data,especially in China.The purpose of this study was to describe the clinical characteristics of ACL injury on a large cohort.Methods Between 1993 and 2007,a total of 4355 ACL deficient inpatients (612 athletes and 3743 non-athletes) were registered.Data were collected using a special database system.And the distributions of characteristics in different groups were compared and analyzed statistically.Results All subjects were confirmed with ACL tear during surgery.Statistical analysis revealed that the percentage of females in Athlete Group was significantly higher than that in Non-athlete Group (56.05% vs.24.95%,P<0.001).This study also found that sports trauma was the main cause of ACL tears.Soccer,basketball,judo,wrestling and track and field were the five most responsible activities for athletes.The average injury time for athletes was significantly shorter than that for non-athletes (413.3 days vs.717.5 days,P<0.001).Three thousand nine hundred and eight cases were ordered ACL reconstruction (76.04% single-bundle,18.30% double-bundle).Three hundred and forty-five patients (7.92%)were combined with other ligaments injuries,2667 (61.24%) were found with various grades of cartilage lesions,and 3377 (77.54%) were found with meniscal injury.Conclusions Sports trauma was the main cause of ACL tears in China,and reconstruction had become the principal surgical choice.In order to restore knee joint stability and reduce the incidence of cartilage and meniscal injury,patienttailored ACL reconstruction should be suggested at the right moment.展开更多
Objective:To investigate the epidemiological situation of animal bites in Rostam city of Fars province.Methods:This is a cross-sectional study.Cases of animal bites registered in health centers of Rostam city of Fars ...Objective:To investigate the epidemiological situation of animal bites in Rostam city of Fars province.Methods:This is a cross-sectional study.Cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020 were analyzed using the census method.The tool for collecting information was the portal of the Ministry of Health and the registration offices of people who were referred to the rabies center.Results:A total of 628 cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020.The mean age of the injured was(31.3±20.2)years.Of the total injured cases,414(65.9%)were male,and 491(78.2%)lived in villages.Most of the cases were bitten by dogs(n=420,66.8%)and the upper limb was involved in 280(55.2%)cases.In addition,an increasing trend was observed in the incidence of animal bites from 2015 to 2020.Conclusions:The incidence of animal bites in Rostam City is high,and most of the cases occur in rural areas.Considering the injuries caused by animal bites,the risk of rabies transmission,and the high costs of vaccination and serum therapy,it is necessary to hold control,educational,and vaccination programs.展开更多
AIM:To compare the feature of ocular trauma between normalized period and the COVID-19 epidemic period in China,and to provide a profile for eye injuries in special times in future.METHODS:This is a multi-center cross...AIM:To compare the feature of ocular trauma between normalized period and the COVID-19 epidemic period in China,and to provide a profile for eye injuries in special times in future.METHODS:This is a multi-center cross-sectional study with 30 participated hospitals involving the China Ocular Trauma Society members.All hospitalized cases who visited the Ophthalmology Department in participated hospitals with eye injuries during the normalized period(2019)and the COVID-19 epidemic period(2020)were included in this study.Demographic characteristic of cases,date of injury,sites and types of injury were collected.RESULTS:This study involved 13525(61 cases with both eyes)injured cases.There were 7269(53.74%)eyeinjured cases and 6256(46.26%)eye-injured cases in 2019 and 2020 separately.Compared with 2019,the incidence of ocular trauma in retirees,housewives and unemployed increased with year-on-year of 4.96%,102.67%,and 11.64%among all occupations.In 2020,the incidence of eye injuries decreased in all injury sites except for an increase in home(30.29%year-on-year).The incidence of mechanical eye injuries decreased,while that of nonmechanical eye injuries(chemical/thermal/radiation)increased(47.45%year-on-year).There were 255(3.51%,255/7269)and 376(6.01%,376/6256)non-mechanical injured cases in 2019 and 2020(Pearson Chi^(2)=47.33,P<0.001)separately.CONCLUSION:During the COVID-19 epidemic period,the total cases of ocular trauma decrease but the proportion of non-mechanical ocular trauma increase.Penetrating is still the highest proportion among all types of mechanical ocular trauma.From a preventive point of view,protection for retired persons,housewives and unemployed persons should be improved during public health events period.展开更多
文摘To study incidence characteristics and causes of injury, and its medical consequences in school children of China. Methods A total of 2 553 school children aged 7-16 years were recruited from Shantou City in Gunagdong by cluster sampling method, and were investigated with questionnaires on cases of injuries occurred among them from October 1, 1996 to September 30, 1997. Results Injuries tended to increase with children抯 age, with an overall incidence rate of 37.96%, higher in boys than in girls (P<0.05); and 38.1% of children had more than two episodes of injury during this period. Falls took leading place of injury incidence both in boys and girls and in all age groups. Most injuries occurred when they were playing, sporting, riding and walking at home or in school. Self-inflicted injury ranked the first place of all injuries, followed by hurt caused by others (classmates, sibling or others). Moderate and serious injuries accounted for 8% of the total with a disability rate of 121.4/100 000. Conclusions Currently, injury has become one of the serious public health problems in China. For the improvement of children survival, it is crucial to reduce their injury to strengthen research on child safety and to implement safety-promotion programs.
文摘Both domestic and foreign terror incidents are an unfortunate outgrowth of our modern times from the Oklahoma City bombings, Sarin gas attacks in Japan, the Madrid train bombing, anthrax spores in the mail, to the World Trade Center on September 11 th, 2001. The modalities used to perpetrate these terrorist acts range from conventional weapons to high explosives, chemical weapons, and biological weapons all of which have been used in the recent past. While these weapons platforms can cause significant injury requiring critical care the mechanism of injury, pathophysiology and treatment of these injuries are unfamiliar to many critical care providers. Additionally the pediatric population is particularly vulnerable to these types of attacks. In the event of a mass casualty incident both adult and pediatric critical care practitioners will likely be called upon to care for children and adults alike. We will review the presentation, pathophysiology, and treatment of victims of blast injury, chemical weapons, and biological weapons. The focus will be on those injuries not commonly encountered in critical care practice, primary blast injuries, category A pathogens likely to be used in terrorist incidents, and chemical weapons including nerve agents, vesicants, pulmonary agents, cyanide, and riot control agents with special attention paid to pediatric specific considerations.
文摘Traumatic brain injury(TBI)and spinal cord injury(SCI)are leading causes of death and disability worldwide(Center for Disease Control,2006).Both injuries are induced by external traumatic event and likely happen together.After the primary traumatic incident,the secondary injury,including ischemic,inflammatory,metabolic and biochemical cascades,is likely more devastating(Blumbergs,1997).To date,all clinical trials have failed to cure TBI and SCI,due to the
基金the Research Vice-Chancellor of Shiraz University of Medical Sciences for inancially supporting the research(Grant No.25125).
文摘Purpose:Spine injury is one of the leading causes of death and mortality worldwide.The objective of this study was to determine the incidence,pattern and outcome of trauma patients with spine injury referred to the largest trauma center in southern Iran during the last 3 years.Methods:This is a cross-sectional study conducted between March 2018 and June 2021 in the largest trauma center in the southern Iran.The data collection form included the age,sex,injury location(cervical,thoracic,and lumbar),cause of injury(traffic accidents,falls,and assaults),length of hospital stay,injured segment of spine injury,severity of injury,and outcome.Statistical analyzes were performed using SPSS software version 24.Results:Totally 776 cases of spine injury were identified.The spine injury rate was 17.0%,and the mortality rate was 15.5%.Cervical spine injury(20.4%)more often occulted in motorcycle accident,and thoracic spine injury(20.1%)occulted in falls.The highest and lowest rates of spine injurys were related to lumbar spine injury(30.2%)and cervical spine injury(21.5%),respectively.There was a statistically significant relationship between the mechanism of injury and the location of spine injury(p<0.001).And patients with lumbar spine injury had the highest mortality rate(16.7%).Injury severity score(OR=1.041,p<0.001)and length of stay(OR=1.018,p<0.001)were strong predictors of mortality in trauma patients with spine injury.Conclusion:The results of the study showed that the incidence of traumatic spine injury rate was approximately 17.0%in southern of Iran.Road traffic injury and falls are the common mechanism of injury to spine.It is important to improve the safety of roads,and passengers,as well as work envi-ronment,and improve the quality of cars.Also,paying attention to the pattern of spine injury may assist to prevent the missing diagnosis of spine injury in multiple trauma patients.
基金supported by the Netherlands Organisation for Health Research and Development(ZonMW)(Grant No.50-53600-98-104)China Scholarship Council(CSC)(Grant No.202106100138)。
文摘Background:Achilles tendinopathy(AT)is a common problem among runners.There is only limited evidence for risk factors for AT,and most studies have not defined the AT subcategories.No study has compared the incidence and risk factors between insertional AT and midportion AT,though they are considered distinct.This study aimed to assess incidence and risk factors of AT based on data from a large prospective cohort.The secondary aim was to explore differences in risk factors between insertional and midportion AT.Methods:Participants were recruited from among registered runners at registration for running events.Questionnaires were completed at baseline,1 month before the event,1 week before the event,and 1 month after the event.Information concerning demographics,training load,registered events,and running-related injuries were collected at baseline.The follow-up questionnaires collected information about new injuries.A pain map was used to diagnose midportion and insertional AT.The primary outcome was the incidence of AT.Multivariable logistic regression analysis was applied to identify risk factors for the onset.Results:We included 3379 participants with a mean follow-up of 20.4 weeks.The incidence of AT was 4.2%.The proportion of insertional AT was 27.7%and of midportion AT was 63.8%;the remaining proportion was a combined type of insertional and midportion AT.Men had a significantly higher incidence(5%,95%confidence interval(95%CI):4.1%-6.0%)than women(2.8%,95%CI:2.0%-3.8%).AT in the past12 months was the most predominant risk factor for new-onset AT(odds ratio(OR)=6.47,95%CI:4.27-9.81).This was similar for both subcategories of AT(insertional:OR=5.45,95%CI:2.51-11.81;midportion:OR=6.96,95%CI:4.24-11.40).Participants registering for an event with a distance of 10/10.55 km were less likely to develop a new-onset AT(OR=0.59,95%CI:0.36-0.97)or midportion AT(OR=0.47,95%CI:0.23-0.93).Higher age had a significant negative association with insertional AT(OR=0.97,95%CI:0.94-1.00).Conclusion:The incidence of new-onset AT among recreational runners was 4.2%.The proportion of insertional and midportion AT was 27.7%and 63.8%,respectively.AT in the past 12 months was the predominant risk factor for the onset of AT.Risk factors varied between insertional and midportion AT,but we could not identify clinically relevant differences between the 2 subtypes.
文摘AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital.METHODS: Orthotopic liver transplantations performed from January 2006 until September 2012 were retrospectively reviewed(n = 187). Patients with no renal replacement therapy(RRT) before transplantation were classified into four groups according to their highest creatinine plasma level during the first postoperative week. The first group had a peak creatinine level below 12 mg/L, the second group between 12 and 20 mg/L, the third group between 20 and 35 mg/L, and the fourth above 35 mg/L. In addition, patients who needed RRT during the first week after transplantation were also classified into the fourth group. Perioperative parameters were recorded as risk factors, namely age, sex, bodymass index(BMI), length of preoperative hospital stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with β-blocker, angiotensin-converting enzyme inhibitor or non steroidal anti-inflammatory drugs, preoperative creatinine and bilirubin levels, donor status(cardiac death or brain death), postoperative lactate level, need for intraoperative vasopressive drugs, surgical revision, mechanical ventilation for more than 24 h, postoperative bilirubin and transaminase peak levels, postoperative hemoglobin level, amount of perioperative blood transfusions and type of immunosuppression. Univariate and multivariate analysis were performed using logistic ordinal regression method. Post hoc analysis of the hemostatic agent used was also done.RESULTS: There were 78 patients in group 1(41.7%), 46 in group 2(24.6%), 38 in group 3(20.3%) and 25 in group 4(13.4%). Twenty patients required RRT: 13(7%) during the first week after transplantation. Using univariate analysis, the severity of renal dysfunction was correlated with presence of ascites and prior bacterial infection, preoperative bilirubin, urea and creatinine level, need for surgical revision, use of vasopressor, postoperative mechanical ventilation, postoperative bilirubin and urea, aspartate aminotransferase(ASAT), and hemoglobin levels and the need for transfusion. The multivariate analysis showed that BMI(OR = 1.1, P = 0.004), preoperative creatinine level(OR = 11.1, P < 0.0001), use of vasopressor(OR = 3.31, P = 0.0002), maximal postoperative bilirubin level(OR = 1.44, P = 0.044) and minimal postoperative hemoglobin level(OR = 0.059, P = 0.0005) were independent predictors of early post-liver transplantation renal dysfunction. Neither donor status nor ASAT levels had significant impact on early postoperative renal dysfunction in multivariate analysis. Absence of renal dysfunction(group 1) was also predicted by the intraoperative hemostatic agent used, independently of the extent of bleeding and of the preoperative creatinine level.CONCLUSION: More than half of receivers experienced some degree of early renal dysfunction after liver transplantation. Main predictors were preoperative renal dysfunction, postoperative anemia and vasopressor requirement.
基金This work was supported by the Non-profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(No.2019PT320020).
文摘Background:Acute kidney injury(AKI)is a common and serious complication following lung transplantation(LTx),and it is associated with high mortality and morbidity.This study assessed the incidence of AKI after LTx and analyzed the associated perioperative factors and clinical outcomes.Methods:This retrospective study included all adult LTx recipients at the China-Japan Friendship Hospital in Beijing between March 2017 and December 2019.The outcomes were AKI incidence,risk factors,mortality,and kidney recovery.Multivariate analysis was performed to identify independent risk factors.Survival analysis was presented using the Kaplan-Meier curves.Results:AKI occurred in 137 of the 191 patients(71.7%),with transient AKI in 43(22.5%)and persistent AKI in 94(49.2%).AKI stage 1 occurred in 27/191(14.1%),stage 2 in 46/191(24.1%),and stage 3 in 64/191(33.5%)of the AKI patients.Renal replacement therapy(RRT)was administered to 35/191(18.3%)of the patients.Male sex,older age,mechanical ventilation(MV),severe hypotension,septic shock,multiple organ dysfunction(MODS),prolonged extracorporeal membrane oxygenation(ECMO),reintubation,and nephrotoxic agents were associated with AKI(P<0.050).Persistent AKI was independently associated with pre-operative pulmonary hypertension,severe hypotension,post-operative MODS,and nephrotoxic agents.Severe hypotension,septic shock,MODS,reintubation,prolonged MV,and ECMO during or after LTx were related to severe AKI(stage 3)(P<0.050).Patients with persistent and severe AKI had a significantly longer duration of MV,longer duration in the intensive care unit(ICU),worse downstream kidney function,and reduced survival(P<0.050).Conclusions:AKI is common after LTx,but the pathogenic mechanism of AKI is complicated,and prerenal causes are important.Persistent and severe AKI were associated with poor short-and long-term kidney function and reduced survival in LTx patients.
基金the Humanities and Social Sciences Research Planning Fund Project of the Ministry of Education(Project Number 20YJAZH007)It was also supported by the Social and People’s Livelihood Technology in Nantong City‒General Project(Project Number MS12019038).
文摘Purpose:The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders.Methods:We systematically searched PubMed,Web of Science,and MEDLINE for studies on injury incidence published from inception to April 2020.Injury data were extracted,alongside information on injury location,severity,type,cause,and sport discipline.Incidence of injuries was presented per 1000 athlete-days,with 95%confidence intervals(95%CIs).Results:The search identified 462 articles,and 22 were included in our review.The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days(95%CI:2.97-4.01).Lower extremity had the highest injury incidence(1.54 per 1000 athletedays,95%CI:1.24-1.84).Incidence rates of slight,mild,moderate,and severe injuries were 0.26,0.31,0.57,and 0.59 per 1000 athlete-days,respectively.Contusion had the highest incidence rate(1.82 per 1000 athlete-days,95%CI:1.01-2.63).The most common cause of injury was contact trauma(3.20 per 1000 athlete-days,95%CI:1.32-5.08).Freestyle skiing had the highest incidence rate(6.83 per 1000 athlete-days,95%CI:4.00-9.66),and Nordic skiing had the lowest rate(2.70 per 1000 athlete-days,95%CI:1.94-3.46).Conclusion:Professional skiers and snowboarders have a substantial risk of sustaining injuries.Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.
文摘Background Clinical features of anterior cruciate ligament (ACL) injury are important for its prevention,diagnosis and treatment.However,few studies have reported such data,especially in China.The purpose of this study was to describe the clinical characteristics of ACL injury on a large cohort.Methods Between 1993 and 2007,a total of 4355 ACL deficient inpatients (612 athletes and 3743 non-athletes) were registered.Data were collected using a special database system.And the distributions of characteristics in different groups were compared and analyzed statistically.Results All subjects were confirmed with ACL tear during surgery.Statistical analysis revealed that the percentage of females in Athlete Group was significantly higher than that in Non-athlete Group (56.05% vs.24.95%,P<0.001).This study also found that sports trauma was the main cause of ACL tears.Soccer,basketball,judo,wrestling and track and field were the five most responsible activities for athletes.The average injury time for athletes was significantly shorter than that for non-athletes (413.3 days vs.717.5 days,P<0.001).Three thousand nine hundred and eight cases were ordered ACL reconstruction (76.04% single-bundle,18.30% double-bundle).Three hundred and forty-five patients (7.92%)were combined with other ligaments injuries,2667 (61.24%) were found with various grades of cartilage lesions,and 3377 (77.54%) were found with meniscal injury.Conclusions Sports trauma was the main cause of ACL tears in China,and reconstruction had become the principal surgical choice.In order to restore knee joint stability and reduce the incidence of cartilage and meniscal injury,patienttailored ACL reconstruction should be suggested at the right moment.
文摘Objective:To investigate the epidemiological situation of animal bites in Rostam city of Fars province.Methods:This is a cross-sectional study.Cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020 were analyzed using the census method.The tool for collecting information was the portal of the Ministry of Health and the registration offices of people who were referred to the rabies center.Results:A total of 628 cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020.The mean age of the injured was(31.3±20.2)years.Of the total injured cases,414(65.9%)were male,and 491(78.2%)lived in villages.Most of the cases were bitten by dogs(n=420,66.8%)and the upper limb was involved in 280(55.2%)cases.In addition,an increasing trend was observed in the incidence of animal bites from 2015 to 2020.Conclusions:The incidence of animal bites in Rostam City is high,and most of the cases occur in rural areas.Considering the injuries caused by animal bites,the risk of rabies transmission,and the high costs of vaccination and serum therapy,it is necessary to hold control,educational,and vaccination programs.
基金Supported by National Natural Science Foundation of China(No.82020108007,No.81830026)Beijing-Tianjin-Hebei Special Project(No.20JCZXJC00180)。
文摘AIM:To compare the feature of ocular trauma between normalized period and the COVID-19 epidemic period in China,and to provide a profile for eye injuries in special times in future.METHODS:This is a multi-center cross-sectional study with 30 participated hospitals involving the China Ocular Trauma Society members.All hospitalized cases who visited the Ophthalmology Department in participated hospitals with eye injuries during the normalized period(2019)and the COVID-19 epidemic period(2020)were included in this study.Demographic characteristic of cases,date of injury,sites and types of injury were collected.RESULTS:This study involved 13525(61 cases with both eyes)injured cases.There were 7269(53.74%)eyeinjured cases and 6256(46.26%)eye-injured cases in 2019 and 2020 separately.Compared with 2019,the incidence of ocular trauma in retirees,housewives and unemployed increased with year-on-year of 4.96%,102.67%,and 11.64%among all occupations.In 2020,the incidence of eye injuries decreased in all injury sites except for an increase in home(30.29%year-on-year).The incidence of mechanical eye injuries decreased,while that of nonmechanical eye injuries(chemical/thermal/radiation)increased(47.45%year-on-year).There were 255(3.51%,255/7269)and 376(6.01%,376/6256)non-mechanical injured cases in 2019 and 2020(Pearson Chi^(2)=47.33,P<0.001)separately.CONCLUSION:During the COVID-19 epidemic period,the total cases of ocular trauma decrease but the proportion of non-mechanical ocular trauma increase.Penetrating is still the highest proportion among all types of mechanical ocular trauma.From a preventive point of view,protection for retired persons,housewives and unemployed persons should be improved during public health events period.